Surgical treatment in the scope of laparoscopic gastric bypass for morbid obesity and type 2 diabetes mellitus (DM 2) with careful preoperative preparation, a gradual expansion of the diet with the obligatory observance of the recommendations of a nutritionist on the balance of micro- and macronutrients, a gradual increase in the amount of available physical activity in the postoperative period allows not only significantly reduce body weight, but also achieve compensation for obesity-related diseases. The expected development of micro- and macronutrient deficiencies requires an active search for and compensation for these conditions both at the pre- and postoperative stages. The development of postbariatric hypoglycemia confirms the need to comply with dietary recommendations not only at the stage of conservative treatment of obesity and DM 2, but also, no less important, after bariatric surgery.
Levothyroxine steadily maintains its position as the «gold standard» in the treatment of hypothyroidism. Despite the possibility of step-by-step tableted dose titration of levothyroxine, the results of many studies reliably point to the fact that a significant number of patients do not reach the target level of thyroid hormone. One of the main reasons for the therapy ineffectiveness is the inconvenience of levothyroxine sodium regimen for many patients, associated with the need to observe certain time intervals before meals and other medications. The above-mentioned factors have stimulated a number of studies aimed at developing new dosage forms with significant advantages in the pharmacokinetics and pharmacodynamics of drugs. The review provides the latest data on the new dosage forms of levothyroxine. Further large-scale clinical trials are needed for a more reasonable and widespread use of new dosage forms of levothyroxine in clinical practice.
Community-acquired pneumonia (CAP) is one of the leading reasons for background prescribing antibacterial therapy (ABT) in pediatric practice. In 2015, the Russian Pediatric Respiratory Society published a guideline on CAP in children. Objective. To assess compliance with the recommendations of starting ABT for CAP of pediatric inpatients in various regions of the Russia. Materials and methods. We reviewed the medical records of pediatric patients with CAP who were hospitalized in 2017–2018. The study was in 6 regions of the Russia. A total of 793 cases of CAP were studied in children aged 1 month to 16 years. We analyzed data from patients, such as demographic indicators, severity of the disease, the presence and nature of complications, and starting ABT. Results. The patient’s age ranged from 1 month to 16 years (average – 4.33 years). The amount of cases of severe CAP was 5.55%, in the remaining 94.45% of cases there was a moderate CAP. Complications were present among 3.91% of patients. The overwhelming majority of patients received parenteral ABT (more than 89%). In the majority of cases, third-generation cephalosporins (65.2%) were used as starting therapy. Amoxicillin was prescribed in only 4.04% of patients. The combination therapy was used in 13.27% of cases (beta-lactam with macrolides or aminoglycosides used most often). We found a significant discrepancy between the actual practice of the recommendations: excessive use of parenteral and combined ABT, private prescription of 3rd generation cephalosporins and rare prescription of amoxicillin, the use of aminoglycosides (including as monotherapy). Conclusion. The use of antibiotics for CAP in children in Russia is often incorrect, which can reduce the effectiveness of treatment and contribute to an increase in antimicrobial resistance. Increased education of pediatricians in ABT and the introduction of antibiotic control is required to address this problem. Key words: children, community-acquired pneumonia, antibiotic therapy
Williams syndrome (WS), also known as Williams–Beuren syndrome, is a rare genetic disorder affecting many organs and caused by hemizygous deletions of the long arm of chromosome 7 (7q11. 23). In this article, we describe typical pathological changes in the cardiovascular, endocrine, urinary, digestive, and nervous systems, as well as phenotypic characteristics and psychological aspects of this disease. We also cover a correlation between clinical manifestations of WS and genes in the remote area. The article contains a summary of the main recommendations for the treatment of individual manifestations, i.e. pathological conditions associated with this syndrome. Key words: children, Williams syndrome, cardiovascular disorder, hypercalcemia, hypothyroidism, growth retardation, mental retardation
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